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General NPI Number Information
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NPI Number | 1619667920
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Entity Type | Individual
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Provider Name | DIAMOND MONET HARDY
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Gender | Female
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 5849 N MARSHALL ST
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City | PHILADELPHIA
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State | PA
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Zip | 19120
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Country | US
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Telephone | 484-640-8904
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Fax |
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Provider Business Mailing Address
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Address Line | 9450 SW GEMINI DR
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City | BEAVERTON
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State | OR
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Zip | 97008-7105
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Country | US
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Telephone | 484-640-8904
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 219080
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License Number State | PA
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